最后审阅: 30 十月 2021
最后更新: 26 五月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在感染疟疾的风险因素
  • 重症疟疾危险因素包括
  • 发热或发热病史

其他诊断因素

  • 头痛
  • 虚弱
  • 肌痛
  • 关节痛
  • 厌食
  • 腹泻
  • 惊厥
  • 恶心和呕吐
  • 腹痛
  • 苍白
  • 肝脾肿大
  • 黄疸
  • 意识水平改变。
  • 低血压
  • 无尿或少尿

危险因素

  • 前往疫区旅行
  • 药物预防不足或未采用。
  • 流行地区不使用杀虫剂处理的蚊帐
  • 到流行地区旅行,返回的本地定居移民
  • 宿主免疫低(导致严重临床表现)
  • 孕妇(重症疾病)。
  • 年龄<5岁(重症疾病)
  • 免疫缺陷患者(重症疾病)
  • 高龄患者(重症疾病)
  • 铁摄入(儿童)

诊断性检查

首要检查

  • 吉姆萨染色厚薄血涂片
  • 快速检测试验(RDTs)
  • 全血细胞计数 (FBC)
  • 凝血功能检查
  • 血清电解质、尿素和肌酐
  • 血清肝功能检查
  • 血糖
  • 尿液分析
  • 动脉血气

需考虑的检查

  • 疟疾血液聚合酶链反应 (PCR) 检测
  • 胸部 X 线检查
  • 血液培养
  • 尿液培养
  • 痰培养
  • 腰椎穿刺:
  • HIV 检查
  • 鼻咽拭子行流感PCR检测
  • 头颅 CT

新兴检查

  • 环介导等温扩增

治疗流程

撰稿人

作者

Ron Behrens, MD, FRCP

Honorary Consultant in Tropical and Travel Medicine

Hospitals for Tropical Diseases

Professor emeritus

London School of Hygiene and Tropical Medicine

London

UK

利益声明

RB is an author of a number of references cited in this topic.

鸣谢

Dr Ron Behrens would like to gratefully acknowledge Mariyam Mirfenderesky, Dr Signe Maj Sorensen, Dr Joanna Allen, Dr Simon Warren, and Dr Behzad Nadjm, previous contributors to this topic.

利益声明

MM, SMS, JA, and SW declare that they have no competing interests. BN is an author of a reference cited in this topic.

同行评议者

Blaise Genton, MD

Professor

Head of the Travel Clinic

Consultant of Tropical and Travel Medicine

University Hospital

Project leader

Swiss Tropical and Public Health Institute

Basel

Switzerland

利益声明

BG has received a research grant from Novartis Pharma to assess the impact of the introduction of artemether-lumefantrine (Novartis) as first-line treatment for uncomplicated malaria on mortality of children under 5 years old in 2 districts in Tanzania and travel grants from Novartis Pharma to present the results of the study above. BG is an author of a reference cited in this topic.

David Sullivan, MD

Associate Professor

Malaria Research Institute and Department of Molecular Microbiology and Immunology

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

利益声明

DS has received royalties from antigen provision for a diagnostic test to Inverness. DS with Johns Hopkins University has patents on diagnostic tests that do not require blood.

Walther H. Wernsdorfer, MD

Professor

Institute of Specific Prophylaxis and Tropical Medicine

Medical University of Vienna

Vienna

Austria

利益声明

WHW declares that he has no competing interests.

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